CDC revising Ebola protocol

ATLANTA – Revised guidance for health care workers treating Ebola patients will include using protective gear “with no skin showing,” a top federal health official said Sunday, and the Pentagon announced it was forming a team to assist medical staff in the U.S., if needed.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said those caring for an Ebola patient in Dallas were vulnerable because some of their skin was exposed.

The Centers for Disease Control and Prevention is working on revisions to safety protocols. Earlier ones, he said, were based on a World Health Organization model in which care was given in more remote places, often outdoors, and without intensive training for health workers.

“So there were parts about that protocol that left vulnerability, parts of the skin that were open,” Fauci said.

Health officials had previously allowed hospitals some flexibility to use available covering when dealing with suspected Ebola patients. The new guidelines are expected to set a firmer standard: calling for full-body suits and hoods that protect worker’s necks, setting rigorous rules for removal of equipment and disinfection of hands, and calling for a “site manager” to supervise the putting on and taking off of equipment.

The guidelines are also expected to require a “buddy system,” in which workers check each other as they come in and go out.

The American Nurses Association and other groups have called for better guidance that sets clearer standards on what kind of equipment, how to put it on and how to take it off.

“We’re disappointed that the recommendations are still not available,” association President Pamela Cipriano said. “Having a lag in official direction from the CDC doesn’t instill the greatest confidence in their ability to rapidly respond.”

Cipriano said she understands the guidance will also include a call for anterooms, apart from the patient room, where protective equipment must be put on and taken off.

The push stems from the infection of two nurses at a Dallas hospital who treated an Ebola-infected patient named Thomas Eric Duncan — the first person diagnosed with the virus in the U.S.

The nurses, Nina Pham and Amber Joy Vinson, were diagnosed with Ebola less than a week later. Officials say how they were infected remains a mystery.

Nurses have voiced concern that they have never cared for Ebola patients before and feel unprepared and underequipped. “If hospital administrators had to take care of Ebola patients, they would have the gold standard and hazmat suits,” said RoseAnn DeMoro, executive director of National Nurses United, a union with 185,000 members.

In some places that do have the suits, nurses have not practiced taking them on and off.

“The hospital is sending them essentially a link to the CDC website. That’s not preparation. That’s like a do-it-yourself manual,” DeMoro said.

Ebola’s incubation period is 21 days, and Fauci noted that mark was being reached Sunday for Texas Health Presbyterian Hospital workers who first treated Duncan.

“The ones now today that are going to be ‘off the hook’ are the ones that saw him initially in the emergency room,” said Fauci.

Duncan was seen at the hospital on Sept. 26 and sent home with antibiotics. He returned by ambulance and was admitted Sept. 28, and died of Ebola Oct. 8.